Glycaemic index of selected staple carbohydrate-rich foods commonly consumed in Botswana

Objectives: Data on the glycaemic index (GI) of foods commonly consumed in Botswana are lacking. The present study aimed to evaluate the GI of some of the staple carbohydrate-rich foods eaten in Botswana.Design, setting and subjects: Fifty university student volunteers were divided into five groups. Members of each group consumed different test foods based on wheat, maize, sorghum, millet and morama beans to supply 50 g of available carbohydrate after 10-12 hours of overnight fasting. GI was determined using a standard method with white bread.Outcome measures: The GI values were calculated after measuring blood glucose levels before and after ingestion at 0, 15, 30, 45, 60, 90 and 120 minutes.Results: The results showed a clear variation in the GI values for the same food when consumed by different individuals. In addition, variations were observed in the GI values of test foods based on the same material. On average, wheat-based foods exhibited the highest GI values (103.1), followed by millet-based foods (95.3), sorghum-based foods (92.5), maize-based foods (9.1) and morama-based foods (86.4). Of the tested food, mapakiwa (wheat-based) had the highest GI (110.6) whereas roasted morama had the lowest GI (82.8).Conclusion: These results could form the basis of dietary advice to consumers, and particularly patients with diabetes. Further studies are needed on more of the commonly consumed foods in Botswana.Keywords: glycaemic index, carbohydrate-rich foods, Botswan

BENCHMARKING PERFORMANCE MEASUREMENT SYSTEMS IN BOTSWANA’S CONSTRUCTION SECTOR

The performance of Botswana’s construction industry has been steadily declining in recent years. Furthermore, the industry has been docked with many projects that are not delivered on time, go over budget, sub-standard quality or are just abandoned. The frequency of occurrence of such projects has been alarming and has raised the question of whether there is a comprehensive system in place to monitor and control these projects. Some of the adverse effects of these delays and misappropriations are; costs escalating above budgeted values and quality of the deliverables shifting from the standard and agreed specification. Performance Measurement Systems (PMS) can be used to determine progress towards achieving certain goals and milestones in the life cycle of a project. These PMS are not new to the construction industry as they have been adopted in the industry for some time now. Therefore, the advantages of employing or implementing such systems are well documented but a lot of troubles apparently solvable by PMS are still encountered within Botswana’s construction industry.  A research survey was conducted on construction companies in Botswana with the purpose of finding out the extent of adoption of performance/progress measurement systems in Botswana’s construction industry and the barriers to their implementation in the industry. From the research it was found that most companies have not adopted PMS due to lack of understanding on the methods.&nbsp

Graduates' evaluations of the Master of Nursing Science degree programme offered by the University of Botswana

The Master of Nursing Science (MNS) programme offered by the University of Botswana needed to be reviewed so that it could be synchronised with prevailing trends within the university, nationally, regionally, and internationally. The purpose of this customer satisfaction survey was to determine the extent to which these graduates' expectations had been met. The findings could provide ideas and inputs for reviewing this programme. The population comprised graduates for the period 1998-2007. A questionnaire with closed and open-ended questions was used to collect data. A convenience and snowball sampling method was employed. Descriptive statistics and content analysis methods were used to analyse quantitative and qualitative data respectively. Of the 53 respondents, 92.5% were females and 7.5% were males. These 53 returned the questionnaires, representing a response rate of 85.5%. Graduates were happy about the programme, but suggested some improvements. A summary of recommendations is presented, supported by relevant literature

A Synthesis of Effective Practices of Managing Succession Planning in Accounting Firms in Botswana

Succession planning continues to be one of the major issues facing the future of many accounting firms. Although it is inevitable for the current senior managers to leave their current posts due to resignations, retirement, ill-health, death or some other reason, organizations find themselves without a succession plan in place to take-over from the departed senior managers. Many firms have closed soon after the departure of a senior manager. In most cases, firms shut down due to the lack of qualified successors. Many firms have not developed prospective successors who are fit to form part of top management in future. They face operational challenges during the transition period to an extent of closing down their businesses. Many firms lag behind in terms of having smooth successions. They lack the knowledge and skills in succession procedures and have no clue on how to mitigate the problems they face during transition periods. Many studies on succession planning are based on family owned businesses. Researchers like van der Merwe (2011), Sardeshmukh and Corbet (2011), Stewart and Hitt (2012) and DeRue and Ashford (2010) have focused on family succession planning. Little is known about how accounting firms develop their successors. The main purpose of this study is to explore how accounting firms build up a succession plan that does not disrupt the operations of the firm. By exploring the best practices which can be adapted, accounting firms can manage succession from one generation of managers to the next without disruptions during the transition period. Through a qualitative analysis of practices of two accounting firms in Botswana, it can be concluded that accounting firms maintain smooth successions by having scheduled recruitment procedures and a skills matrix which help them identify the qualities and experiences required at the top management level to support strategic plans. Accounting firms are fully aware of how operations can be affected by transition problems, and how to mitigate such problems. They offer on-the-job training to successors with the view of making them quickly get accustomed to managing an accounting firm. Both internally and externally recruited top management personnel are selected on the basis of their experience levels, so settling down is not a problem to them since they have broad insights of what do in an accounting firm. For a business to ensure its continuity there is need to train the prospective future managers and acclimatize them to the running of the business before the departure of current managers. This study recommends that accounting firms should have well thought out succession plans, which can be easily implemented, can fit well into their strategic plans and is able to carry the business into the future

Risk factors for burnout among nurses and doctors in selected hospitals of Botswana

The purpose of the presentation is to share areas of the work environment that doctors and nurses participating in the study found frustrating so as to encourage sharing of ideas

Collaborative clinical learning environment for nursing students: Perspectives from Botswana

Session presented on Saturday, March 18, 2017: A collaborative clinical learning environment plays an important role in preparing nursing students to working with diverse patient care team. Collaboration could help in cultivating a smooth flow of work in a hospital environment where uncertainties are almost unavoidable (Hine, Fenton, & Custance, 2015). A collaborative clinical learning environment in nursing education can be defined as an atmosphere where various professionals participating in patient care support and enhance one another such that patients\u27 needs are met, job satisfaction is enhanced and students learning is facilitated (Melrose, Park, & Perry, 2015). This presentation reports on nursing students\u27 perspectives and clinical staff about a collaborative clinical learning environment at a large teaching hospital in Botswana

The social, mental, and physical health impacts of the COVID-19 pandemic on people with HIV: protocol of an observational International Multisite Study

As the COVID-19 pandemic spread across the world, immunocompromised individuals such as people with HIV (PWH) may have faced a disproportionate impact on their health and HIV outcomes, both from COVID-19 and from the strategies enacted to contain it. Based on the SPIRIT guidelines, we describe the protocol for an international multisite observational study being conducted by The International Nursing Network for HIV Research, with the Coordinating Center based at the University of California, San Francisco (UCSF) School of Nursing. Site Principal Investigators implement a standardized protocol to recruit PWH to complete the study online or in-person. Questions address demographics; HIV continuum of care indicators; mental and social health; COVID-19 and vaccination knowledge, attitudes, behaviors, and fears; and overall outcomes.Results of this study will contribute to knowledge that can inform responses to future public health crises to minimize their impacts on vulnerable populations such as PWH

Impediments for the Uptake of the Botswana Government's Male Circumcision Initiative for HIV Prevention

Botswana remains one of the countries with high prevalence of HIV infection with a population prevalence rate of 17.6 in 2008. In 2009, the Ministry of Health launched male circumcision as an additional strategy to the already existing HIV preventive efforts. The purpose of this paper is to share what the participants of a survey to evaluate a short-term male circumcision communication strategy in seven health districts of Botswana reported as impediments for the program's uptake. Qualitative data were obtained from 32 key informants and 36 focus group discussions in 2011. Content analysis method was used to analyze data and to derive themes and subthemes. Although male circumcision was generally acceptable to communities in Botswana, the uptake of the program was slow, and participants attributed that to a number of challenges or impediments that were frustrating the initiative. The impediments were organized into sociocultural factors, knowledge/informational factors, and infrastructural and system factors

Processes of managing medications in selected health facilities in country X

Session presented on Thursday, July 21, 2016 and Friday, July 22, 2016: Purpose: The purpose of this presentation is to share preliminary findings on the processes of medication management. The presentation highlights the role played by each cadre of health care providers at each stage of medication management and structures and processes in place for preventing and managing medication errors. Methods: A descriptive cross-sectional mixed- methods design was used. The study was conducted in urban, peri-urban and rural health facilities in country X. The selected health facilities were a mix of referral, district and primary hospitals as well as clinics and health posts. A total of 12 sites were selected. Following selection of health facilities, study participants were categorized by their cadres before simple random selection was done. The number selected for each cadre was proportional to the total number of candidates in a given cadre at a given health facility. Descriptive statistics was used to analyze the preliminary findings. Results: The sample consisted of 53 participants with an uneven distribution of gender as there were 22 males and 31 females. The age ranged between 24 to 63 years. The descriptive data shows that prescription is mostly done by doctors (88.6%) and nurses (53.8%) while transcription and administration was mainly done by nurses (Randolph, 2013). Dispensing of medications was done by pharmacist/technician, nurses and doctors. It was noted that both nurses and doctors in primary health care settings were involved in prescription while in acute care settings prescription was limited to doctors except for nurse anesthetists. However in the private facilities prescription was done by doctors only. Most respondents (88.7%) were certain that their curricula covered medication errors. In-service and workshops addressing medication errors were reported but were uncommon. Medication counselling was most prevalent at dispensing and was rarely done during prescription and administration. It makes sense that counselling is more frequently provided at the dispensary (Al-Khani, Moharram & Aljadhey, 2014) than other areas because at prescription for instance, the health care provider may want to spend less time with the patient hoping counselling will be done at dispensing and administration. Supervision and self-checking was common at dispensing and uncommon during prescription, administration and transcription. Peer checking was reported at all stages. Health care providers did not take medication self-checking as a routine. Mixing of medications was mostly done in the wards but few stated that mixing was also done at the pharmacy. Those involved in mixing were nurses, pharmacists and at times doctors. Participants stated that protocols for mixing injectable medications were available, and these included medication leaflets. It was also reported that new staff members were trained on mixing injectable medications. Some new staff were not offered on the job training on mixing injectable drugs; however protocols were available to guide them. Public facilities reported that most medical and medication errors made by staff were not reported, the same observation was made on medication errors staff discovered. Medication errors were therefore not reported in public facilities. This was different with the private health facilities where all medical errors including medication errors were reported. The public sector participants disagreed that there was a written protocol for prevention, detection, reporting and tracking of medication errors. However the private sector respondents agreed to the availability of a tool for reporting medication errors but only 50% have used it. Conclusion: The findings on who prescribes are in line with the Drug and Related Substance Act of country X which provides for prescriptive authority to doctors and nurses. Transcription included telephone orders, transfer of medication orders to new drug sheet and writing a refill prescription. The report shows that transcription is done by nurses. Nurses spend most of the time with patients and receive orders when necessary. Medication administration was mostly done by nurses, and doctors also do in some situations. Dispensing was primarily done by pharmacy personnel, but nurses also dispensed probably because there is still shortage of pharmacists and pharmacy technicians in the country. Untrained staff was not engaged in medication management except in administration of dressing ointments and creams. It is evident that none of the facilities had a room dedicated for mixing of medications, which poses a risk for medication errors due to distractions. Gaps identified in medication management were; limited counselling during prescription and administration, absence of a room dedicated for mixing intravenous medications and solutions, absence of protocols on mixing and preparing injectable medications in some situations, lack of training of new staff on mixing of intravenous medications in some situations and instances of failure to report medical errors including medication errors in public facilities

Perspectives of people living with HIV toward healthcare providers: Insights into multicultural health literacy

Purpose: To further our understanding about relationship influences that impact health literacy, the purpose of this study was to characterize the perspectives of a culturally diverse group of people living with HIV (PLWH) toward their health care providers. Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate decisions related to their health. Low health literacy is associated with poor health outcomes. Use of preventive services, knowledge about medical conditions and treatment, rates of hospitalization, health status, and health care costs are all linked to health literacy. Although low health literacy can occur in any population, the burden of low health literacy disproportionately affects racial and ethnic minorities and individuals with low income levels. For PLWH, lower health literacy is associated with lower CD4 cell counts, higher viral loads, and a decreased likelihood of taking antiretroviral medication. Adequate health literacy is critical for treatment adherence and for promoting healthy behaviors in the daily lives of PLWH. In order to achieve and maintain HIV viral suppression, adherence to HIV treatment regimens requires a constant, near-perfect medication adherence rate for many medications. Further, the ability to seek and sustain treatment is contingent on one s ability to navigate a complex health care system. Proficiency in health literacy skills is critical to this process. Methods: Twenty-eight focus groups consisting of people living with HIV were conducted in eight sites representing multicultural backgrounds in the United States, Puerto Rico and Botswana. Responses from audio-recorded focus group interviews were analyzed using content analysis. Results: Five themes emerged from the data that exemplified characteristics and relationship qualities valued by the participants living with HIV in their health care providers - partnership, knowledgeable health care provider, understandable language, respect, and knowing the person. Participants valued respectful partnership relationships with a knowledgeable health care provider who used understandable language and regarded them as a person of worth. Conclusion: Relationship quality between patients and health care providers was central to facilitating and enhancing the health literacy of PLWH and likely their retention in care